The Modified Barium Swallow Study, while a clinically useful tool, remains a
subjective test. Evidence, rather than opinion, should guide clinical
decision-making.

The Modified Barium Swallow Impairment Profile, or MBSImP, is an evidence-based,
standardization of the MBS study in adults. The MBSImP assesses 17 critical
components of swallowing and provides an objective profile of the physiologic
impairment affecting adult swallowing function.

For the first time, the MBSImP provides the means for clinicians to communicate MBS
study results in a standardized, evidence-based manner that is consistent, specific,
and accurate.

TESTIMONIALS:

What your colleagues are saying about the MBSImP:

“I did the online course and I found it to be exceptional. . . It’s objective and
allows
for better communication between trained therapists. Can’t recommend it enough.”

“I really enjoyed the course and am recommending it to all my colleagues. It was
positively challenging. I feel so much more confident when evaluating our VFSS
results now and it truly does save time in the long run.”

“The characteristics for each component are well defined, the videos provide
excellent
examples of the components. The attention to detail is outstanding. The learning is
enhanced by the availability of the replay of the videos for study.”

“I am so excited to have this standardization protocol in place. I have been
frustrated
for a long time with the differences in interpretation of MBSs from one clinician to
another. I think this will add credibility to our profession. I am excited to start
using
the reports and contribute to research!”

Content on this page requires a newer version of Adobe Flash
Player.

A “Registered MBSImP Clinician” is a Speech-Language Pathologist who has successfully
completed the MBSImP Online Training and then scored 80% or higher on the MBSImP
online reliability testing.

Only Registered MBSImP Clinicians will be granted access to the MBSImP online
interface for Patient Data & Reports.

Prerequisite: individuals must have a degree in Speech-Language Pathology in order to
enroll in the MBSImP training and to become Registered MBSImP Clinicians.

Speech-Language Pathologists have made great gains in the assessment and treatment of
swallowing disorders. What has been lacking is a means to communicate MBSS results
in a practical, consistent, and accurate format that supports evidenced-based
practice. The time has come to standardize how we discuss a patient's impairment,
how we target treatment, and how we communicate with physicians, nurses, and our
fellow speech-language pathologists. Through using a standardized approach, like the
MBSImP provides, information obtained and communicated will be valid, comprehensive,
and reliable.

With regard to the MBSS, the
MBSImP standardizes the:

Method of Training

Administration Protocol

Assessment Tool

Vernacular

Analysis and Reporting Methods

For the first time, the MBSImP allows clinicians “to speak the same language” across
the entire Dysphagia care continuum: acute, inpatient rehab, skilled nursing, and
outpatient.

Each of the 17 components has 3 to 5 associated scores that describe progressing
levels of impairment. The score chosen is determined through observation of the
component-specific physiology over the course of the study. Developed and clinically
used over a five year period of research, the MBSImP was proven to be clinically
efficient, with scoring schema that provide valid profiles of impairment and achieve
inter- and intra-rater reliability factors, both greater than 80%, in the hands of
like-trained clinicians.

Proficiency in scoring develops after only a short period of routine clinical use.
Seasoned MBSImP clinicians average 10 to 15 minutes to adequately score a study. The
online interface for Patient Data & Reports was designed for quick, efficient data
entry, with point and click input methods for 95% of fields. Once familiar with the
screens, entry of the data and generation of the study’s report will take under 10
minutes.

The MBSImP-generated report will be detailed and reflective of the study and complies
with Joint Commission requirements for documentation. Each report can be edited and
most EMR systems will allow for importing, uploading or scanning this document into
the EMR.

No. You may continue to submit reports using your hospital's EMR as always. MBSImP
scoring data that you collect may be entered into the MBSImP global dysphagia
registry at a time that is convenient for you.

Keep in mind that the MBSImP’s Patient Data & Reports online user tools will generate
an assessment report for you. This report will be detailed and reflective of the
study and complies with Joint Commission requirements for documentation. Each report
can be edited and most EMR systems will allow for importing, uploading or scanning
this document into the EMR.

Because the assessment is derived through observing specific aspects of physiology
for deviation from an expected norm, the MBSImP’s profile of impairment is not
dependent on the underlying cause of the physiologic change. The scoring system is
also flexible, able to account for boluses not given due to concerns for patient
safety and for additional boluses used to determine the effectiveness of a
compensatory strategy.

The MBSImP provides an assessment that is derived from observation of specific
aspects of physiology, determining the integrity of each to obtain a profile of the
components that are affecting functional swallowing. Decisions regarding oral intake
recommendations and patient management are left to the clinician's experience and
clinical judgment, considering the level of function as influenced by the physical
impairment.

Any clinician having any level of intervention with patients who have impaired
swallowing function, whether this extends to assessment and treatment or treatment
only, will benefit and develop a deeper understanding of the involved physiology,
the potential for impairment, and the influence on function that may result. As the
MBSImP becomes the preferred method of assessment used by the majority of
clinicians, assessment reports will use the MBSImP’s standardized vernacular and
scoring schema. "Speaking the same language" will support optimal patient care.

Yes. The MBSImP was validated by a rigorous, five-year study. Analysis of research
data indicated that the standardized MBSImP provides objective assessment possessing
both inter- and intra-rater reliability greater than 80% when used by like-trained
clinicians. The research was published in Dysphagia Journal in 2008. access
article

Evidence supports that using the MBSImP standardized approach during the MBS study
did not cause unnecessary exposure to radiation. This study found that patients were
exposed to an average of 2.9 minutes of radiation during MBS studies in which the
MBSImP standardized approach was used. Read the study here.

The call for evidence-based practices continues to get louder. The time has come for
us to standardize the MBSS. We owe it to our patients to provide for them optimal
care – care that is consistent, reliable, and supports evidence-based practices. We
owe it to our profession to demonstrate the evidence needed to justify what we do to
payors, patients, and to ourselves.

The MBSImP helps to provide:

Objective Assessment. Clinical decision-making should be based on evidence
rather than opinion. Analysis of research data indicated that the standardized
MBSImP provides objective assessment possessing both inter- and intra-rater
reliability greater than 80% when used by like-trained clinicians.

Better Patient Care. Provide the best care for patients – care that is
consistent, reliable, and supports evidence-based practices.

Efficient & Precise Communication. The standardized approach of the MBSImP
provides a means for you “to speak the same language” as your colleagues within your
facility as well as your colleagues in other facilities. Utilize consistent,
specific, and accurate communication of patient status to other healthcare
professionals through a common vernacular in assessment and reporting.

Professional Competency. Demonstrate your proficiency in the assessment and
treatment of swallowing disorders.

Necessity of Skilled Services. Help to provide invaluable data to the MBSImP’s
global data registry – data that will demonstrate the evidence needed to justify
what we do to payors, physicians, patients, and to ourselves.

Research Data. Contribute to the first and only international data registry
dedicated solely to swallowing dysfunction, providing an adjunct to research that
has never existed, until now.

Investing in the MBSImP helps to increase:

Staff Competency. Demonstrate MBSS competency in new and existing staff to
accrediting agencies through use of a standardized training mechanism of swallowing
physiology and impairment.

Evidence-Based Practice. The MBSImP was validated by a rigorous, five-year
study. The MBSImP provides objective assessment possessing both inter- and
intra-rater reliability greater than 80% when used by like-trained clinicians.

Positive Patient Outcomes. Preparedness of the treating clinician to interpret
findings for targeted treatment even if the MBSS was completed at a different
facility by a different clinician.

Necessity of Skilled Services. Promote the accumulation of data to provide the
evidence needed to justify what we do to payors, patients, and to ourselves.

Medical University of South Carolina (MUSC) Disclaimer:

The health information stored in this electronic software system meets the
requirements of de-identified as stated in 45 Code of Federal Regulations, Part
164.514b(2)(i) of the Health Insurance Portability and Accountability Act (HIPAA).
The requirements of HIPAA do not apply to health information that has been
de-identified [164.502(d)(2)]. Please note the disclosure of a code or other means
of record identification designed to enable this de-identified information to be
re-identified is prohibited. A disclosure of a code can be defined as the release,
transfer, provision of access to, or divulging in any other manner of a
re-identification code outside the entity providing treatment or holding the health
information.

Many facilities have been successful in securing funding to train their SLP staff
through use of operational funds or through use of CEU education funds. The
following PowerPoint presentation offers some points to consider when presenting
funding requests to administration. Permission is granted for downloading and use of
this PowerPoint document.

What your colleagues are saying about the MBSImP:

“I did the online course and I found it to be exceptional. . . It’s objective and
allows
for better communication between trained therapists. Can’t recommend it enough.”

“I really enjoyed the course and am recommending it to all my colleagues. It was
positively challenging. I feel so much more confident when evaluating our VFSS
results now and it truly does save time in the long run.”

“The characteristics for each component are well defined, the videos provide
excellent
examples of the components. The attention to detail is outstanding. The learning is
enhanced by the availability of the replay of the videos for study.”

“I am so excited to have this standardization protocol in place. I have been
frustrated
for a long time with the differences in interpretation of MBSs from one clinician to
another. I think this will add credibility to our profession. I am excited to start
using
the reports and contribute to research!”

Unlimited access to the Learning and Training Zones, even after testing

Free additional testing attempts in the Reliability Zone

Free expert SLP support for component-score questions

Free access to the Patient Data & Reports online clinical tools*

Free posting of the 2.1 CEUs to the ASHA CE Registry*

*for individuals who pass the
reliability testing

5-YEAR RENEWAL:

Registered MBSImP Clinician status is awarded for a period of 5 years. The 5-year
renewal process will consist of a $99 renewal fee and completion of a 2 or 3 hour
CEU training & testing related to the MBSImP.

DISCOUNT:

**Those who have attended or will attend Dr. Bonnie Martin-Harris' MBSImP CE seminar
will receive a tuition credit good toward enrollment in the MBSImP Web-Based
Training. CEUs are offered separately for both the seminar and the web training.
Attending the CE seminar is NOT a requirement to become a Registered MBSImP
Clinician. The only way to become a Registered MBSImP Clinician is through the
web-based training and testing.

You will need to complete the MBSImP Web-Based Training. Those who successfully score
80% or higher within the online Reliability Assessment testing will be awarded 2.1
CEUs, earn the designation of "Register MBSImP Clinician," and be granted access to
the MBSImP online interface for Patient Data & Reports. Only Speech-Language
Pathologists are eligible to become Registered MBSImP Clinicians.

The MBSImP online training, testing, and patient data tools are all web-based. There
is no software to download or install. Everything is accessed via user password at
www.mbsimp.com. The training and testing are divided into 3 zones:

THE LEARNING ZONE: This first zone will utilize 72 adult videofluoroscopy
segments, each combined with state-of-the-art swallow animation, to demonstrate and
explain the 17 physiologic components and scores of the MBSImP.

THE TRAINING ZONE: Within the second zone, participants put the scoring scheme
to practical use through the scoring of each MBSImP component, initially on single,
isolated swallows taken from swallow studies, and then scoring each component on
full studies. Participants will need to score all single swallows then score all
full studies before access will be granted to zone 3, the reliability zone.

THE RELIABILITY ZONE: This is the "testing zone." Participants will be tested
on their newly acquired skill in using the MBSImP to successfully capture and
profile swallowing impairment in adults. Ten swallow studies must be scored. The
scores can be reviewed and changed as needed prior to submitting the full test.
Participants will have the ability to return to zones 1 and 2 as needed as they
progress through the Reliability Assessment testing. Once the scores are submitted
for all 10 studies, notification is provided of either successful completion
(minimum of 80% accuracy) or of the need to repeat the reliability zone testing. The
reliability testing can be repeated as needed until a score of 80% or higher is
achieved.

PATIENT DATA & REPORTS: This fourth area of MBSImP.com is available to those
clinicians who successfully pass the Reliability Zone testing. It contains very
functional online user tools that were designed for daily use by clinicians.

It will require between 20 and 25 hours for most learners to work through the MBSImP
training and pass the online Reliability Assessment testing with a minimum of 80%
accuracy. There are no time limits for completing the training and learners may
re-test as needed in order to achieve the 80% passing threshold.

There are no time limits for completing the training. Once a learner successfully
passes the testing zone and becomes a "Registered MBSImP Clinician” at that time the
“testing zone” is replaced by the Patient Data & Reports online user tools.
Unlimited access to the Learning and Training Zones remain after passing the
testing, allowing for continued study and practice.

Yes. The status of Registered MBSImP Clinician is awarded for a period of 5 years
from date of passing the online reliability testing. The renewal process will
consist of a $99 renewal fee and completion of a 2 or 3 hour CEU training &
testing related to the MBSImP. The fee will include the cost of the training and
awarding of the CEUs.

No, it is not required. The only way to become a Registered MBSImP Clinician is to
complete the MBSImP Web-Based Training. Many will choose to utilize the MBSImP
seminar as a preparatory course to become familiar with the MBSImP methodology and
scoring system. Attendees of the CE seminar will likely be able to complete the
online training in a shorter time.

**In addition, those who have attended or will attend Dr. Bonnie Martin-Harris'
MBSImP CE seminar will receive a tuition credit good toward enrollment in the MBSImP
Web-Based Training. CEUs are offered separately for both the seminar and the web
training.

Yes, student MBSImP accounts are available at reduced cost. To enroll, please email
Tom at tom@northernspeech.com.

The MBSImP x-ray segments and swallow animations are an ideal supplement to
university dysphagia courses as students learn to identify anatomy on x-ray and
begin to assess swallow impairment.
Learners on student accounts will have access to the Learning Zone, the Training
Zone, and the Reliability Zone of MBSImP.com. However, student learners
will not be granted access to the Patient Data and Reports area of
MBSImP.com. Students learners are not eligible to become “Registered MBSImP
Clinicians.”
No CEUs are offered on student accounts.

Instructor Access: For a free preview of the MBSImP, email
tom@northernspeech.com.

Access to this restricted area of MBSImP.com is granted only to those clinicians who
have passed the reliability testing and thus achieved the status of Registered
MBSImP Clinician. There are no additional fees to access this section.

The Patient Data & Reports area includes online, functional user tools that were
designed to be used daily by clinicians to:

To maintain a database of their patients with dysphagia, consisting of
de-identified data that includes diagnoses, MBSImP results, effectiveness of
intervention and patient outcomes.

Generate assessment reports. These editable reports will be detailed and
reflective of the study and comply with Joint Commission requirements for
documentation. View sample MBSImP report.

Track patient progress and outcomes, and demonstrate evidence for treatment.

Access online forums for communication with other Registered MBSImP Clinicians
around the world.

Contribute to the first and only international data registry dedicated solely to
swallowing dysfunction, providing an adjunct to research that has never existed,
until now.

No additional fees apply. This area of MBSImP.com is included with the initial
tuition cost.

No. You may continue to submit reports using your hospital's EMR as always. MBSImP
scoring data that you collect may be entered into the MBSImP global dysphagia
registry at a time that is convenient for you.

Keep in mind that the MBSImP Patient Data & Reports online user tools will generate
an assessment report for you. This report will be detailed and reflective of the
study and complies with Joint Commission requirements for documentation. Each report
can be edited and most EMR systems will allow for importing, uploading or scanning
this document into the EMR.

The health
information stored in this electronic software system meets the requirements of
de-identified as stated in 45 Code of Federal Regulations, Part 164.514b(2)(i) of
the Health Insurance Portability and Accountability Act (HIPAA). The requirements
of HIPAA do not apply to health information that has been de-identified
[164.502(d)(2)]. Please note the disclosure of a code or other means of record
identification designed to enable this de-identified information to be re-identified
is prohibited. A disclosure of a code can be defined as the release, transfer,
provision of access to, or divulging in any other manner of a re-identification code
outside the entity providing treatment or holding the health information.